Abstract-Tennessee EHS-Net Application 2010 Foodborne and waterborne pathogens cause substantial burden of illness. The Tennessee Department of Health (TDH) considers involvement in EHS-Net vital to promoting safe practices, educating environmentalists and epidemiologists in outbreak investigation, preventing illness, adding to the body of generalizable knowledge about food/water safety and environmental contamination, and demonstrating to the public the value of food and water safety measures. This application will demonstrate our EHS-Net objectives, our history of EHS-Net accomplishments, and our future EHS- Net plans. We will continue the interagency approach in EHS-Net Food Program by supporting two full- time environmentalists in two of the state's large, comprehensive food safety programs. These environmental specialists and the EHS-Net PI will actively contribute to all aspects of multi-state food safety projects and participate in steering committee and working group calls. New projects will include the following: 1) complete an introductory survey to fully characterize the 232 grocery stores in Nashville, Davidson County;2) implement food flow and contributing factor evaluation in restaurant- associated foodborne outbreaks statewide;3) evaluate the effectiveness of an ongoing remedial food safety training on the long-term performance low-scoring restaurants;4) integrate use of a standard foodborne illness complaint form into the state's environmental health information system;5) as follow- on to a previous project, analyze the previous eight years of statewide restaurant inspection data. Continued participation in multi-state EHS-Net studies will also remain a high priority. Tennessee's involvement in the EHS-Net Water Safety Program since 2005 has led to numerous improvements in waterborne disease prevention, detection, and investigation. Numerous projects and investigations have enabled interaction with local, state, and federal stakeholders. During 2008-2009, we conducted multi-agency outbreak investigations, including a household sewage outlet cross connected to the water main supplying a small community, a source water contamination in a small community water system, and a municipal waste water treatment bypass to surface streams. With EHS-Net support, the state public health laboratory gained capacity to isolate and speciate Cryptosporidium from stool and environmental field samples. We will continue multistate EHS-Net projects and begin two new locally designed projects identified as priorities for additional study and data collection: 1) to identify and understand species-specific factors associated with the increased reports of cryptosporidiosis in east Tennessee, and 2) collect detailed location and use information for private water wells and onsite sewage disposal systems in Tennessee. PUBLIC HEALTH RELEVANCE: EHS-Net Food Safety-Tennessee 1) Introduction to application Each year in the U.S., foodborne pathogens such as Salmonella, Campylobacter, and E. coli O157:H7 cause millions of illnesses, sometimes with severe outcomes. In recent years, as people eat more food served by restaurants and as ready-to-eat food products are distributed over wider areas, illness and outbreaks caused by contamination of food have gained wider publicity, yet the public does not always consider food safety regulation and food recalls as effective tools in preventing illness. We at the Tennessee Department of Health (TDH) are concerned with preventing foodborne outbreaks by promoting safe food handling practices and by working on local and national levels to understand how these outbreaks occur. We consider involvement in projects such as Environmental Health Specialist (EHS)-Net and FoodNet vital to our work of promoting safe food handling practices, educating environmentalists and epidemiologists in outbreak investigation, preventing illness, and adding to the body of generalizable knowledge about food safety and environmental contamination. This application for funding through Centers for Disease Control (CDC) will demonstrate our objectives in working with EHS-Net, our